J Endocrinol Metab

Journal of Endocrinology and Metabolism, ISSN 1923-2861 print, 1923-287X online, Open Access

Article copyright, the authors; Journal compilation copyright, J Endocrinol Metab and Elmer Press Inc

Journal website http://www.jofem.org

Original Article

Volume 3, Number 4-5, October 2013, pages 98-104

Intraoperative Parathyroid Hormone is a Valuable Indicator of Long Term Cure in Primary Hyperparathyroidism

Figure 1. Boxplot chart of the PTH levels before and 5, 10 and 20 minutes after excision of the parathyroid gland.

**Table 1.** Calcium and PTH Levels at 3 and 6 Months and 1, 2, 3, 4 and 5 Years of Follow-Up in Both Groups
	3 months	6 months	1 year	2 years	3 years	4 years	5 years
N	64	53	69	65	54	53	51	53	28	23	20	15	14	13
Median	9.2	69.6	9.2	60.3	9.2	46.6	9.4	49.4	9.2	52.4	9.1	62.9	9.2	57.4
Inter-quartile range	0.9	74.6	0.6	59.1	0.6	38.3	0.6	50.4	0.5	56.7	0.6	87.2	1.0	36.2
Decreased (%)	10.9	7.5	7.2	6.2	7.4	5.7	7.8	5.7	7.1	0.0	10.0	0.0	14.3	7.7
Normal (%)	84.4	37.7	89.9	52.3	88.9	73.6	88.2	50.9	92.9	65.2	85.0	46.7	78.6	69.2
Increased (%)	4.7	54.7	2.9	41.5	3.7	20.8	3.9	43.4	0.0	34.8	5.0	53.3	7.1	23.1

Table 1. Calcium and PTH Levels at 3 and 6 Months and 1, 2, 3, 4 and 5 Years of Follow-Up in Both Groups

3 months

6 months

1 year

2 years

3 years

4 years

5 years

PTH

Median

9.2

69.6

9.2

60.3

9.2

46.6

9.4

49.4

9.2

52.4

9.1

62.9

9.2

57.4

Inter-quartile range

0.9

74.6

0.6

59.1

0.6

38.3

0.6

50.4

0.5

56.7

0.6

87.2

1.0

36.2

Decreased (%)

10.9

7.5

7.2

6.2

7.4

5.7

7.8

5.7

7.1

0.0

10.0

0.0

14.3

7.7

Normal (%)

84.4

37.7

89.9

52.3

88.9

73.6

88.2

50.9

92.9

65.2

85.0

46.7

78.6

69.2

Increased (%)

4.7

54.7

2.9

41.5

3.7

20.8

3.9

43.4

0.0

34.8

5.0

53.3

7.1

23.1

**Table 2.** Findings in Patients Who Fulfilled the Criterion of 50% Drop in ioPTH With Normal (Group I) or Increased (Group II) PTH After 10 Minutes Post-Excision
	Group I	Group II	P
Weight of the glands and levels of calcium and PTH are expressed as median and interquartile range. SI conversion factors: to convert calcium to millimoles per liter, multiply by 0.25; to convert PTH to nanograms per liter, multiply by 1.
Age (years)	59.88 ± 15.89	62.93 ± 16.14	0.34
Gender			< 0.01
Female (nr patients)	74	24
Male (nr patients)	11	16
Weight removed glands (g)	1.4 (2.2)	3.0 (6.0)	< 0.01
Final diagnosis			0.15
Single adenoma (nr patients)	75	41
Multiglandular disease (nr patients)	11	2
Highest pre-operative calcium (mg/dL)	11.1 (1.4)	11.7 (1.8)	< 0.01
Highest pre-excision PTH	259 (210.5)	863 (1186.5)	< 0.01
Intra-operative PTH - 10’ (pg/mL)	30.1 (20.5)	125.5 (124.9)	< 0.01
Calcium 1.5 months (mg/dL)	9.2 (0.8)	9.1 (1.1)	0.41
Calcium 3 months (mg/dL)	9.4 (0.8)	9.0 (1.1)	0.39
Calcium 6 months (mg/dL)	9.2 (0.6)	9.2 (0.8)	0.83
Calcium 12 months (mg/dL)	9.2 (0.6)	9.2 (0.7)	0.59
PTH 1.5 months (pg/mL)	58.0 (47.2)	73.4 (98.7)	0.16
PTH 3 months (pg/mL)	55.0 (49.9)	124.5 (136.7)	< 0.01
PTH 6 months (pg/mL)	55.9 (48.2)	83.1 (92.6)	< 0.01
PTH 12 months (pg/mL)	46.3 (39.6)	61.0 (57.6)	0.07
Calcium and PTH at 6 months			0.01
Normal calcium/normal PTH (nr patients)	26	9
Normal calcium/ high PTH (nr patients)	9	13

Table 2. Findings in Patients Who Fulfilled the Criterion of 50% Drop in ioPTH With Normal (Group I) or Increased (Group II) PTH After 10 Minutes Post-Excision

Group I

Group II

Weight of the glands and levels of calcium and PTH are expressed as median and interquartile range. SI conversion factors: to convert calcium to millimoles per liter, multiply by 0.25; to convert PTH to nanograms per liter, multiply by 1.

Age (years)

59.88 ± 15.89

62.93 ± 16.14

0.34

Gender

< 0.01

Female (nr patients)

Male (nr patients)

Weight removed glands (g)

1.4 (2.2)

3.0 (6.0)

< 0.01

Final diagnosis

0.15

Single adenoma (nr patients)

Multiglandular disease (nr patients)

Highest pre-operative calcium (mg/dL)

11.1 (1.4)

11.7 (1.8)

< 0.01

Highest pre-excision PTH

259 (210.5)

863 (1186.5)

< 0.01

Intra-operative PTH - 10’ (pg/mL)

30.1 (20.5)

125.5 (124.9)

< 0.01

Calcium 1.5 months (mg/dL)

9.2 (0.8)

9.1 (1.1)

0.41

Calcium 3 months (mg/dL)

9.4 (0.8)

9.0 (1.1)

0.39

Calcium 6 months (mg/dL)

9.2 (0.6)

9.2 (0.8)

0.83

Calcium 12 months (mg/dL)

9.2 (0.6)

9.2 (0.7)

0.59

PTH 1.5 months (pg/mL)

58.0 (47.2)

73.4 (98.7)

0.16

PTH 3 months (pg/mL)

55.0 (49.9)

124.5 (136.7)

< 0.01

PTH 6 months (pg/mL)

55.9 (48.2)

83.1 (92.6)

< 0.01

PTH 12 months (pg/mL)

46.3 (39.6)

61.0 (57.6)

0.07

Calcium and PTH at 6 months

0.01

Normal calcium/normal PTH (nr patients)

Normal calcium/ high PTH (nr patients)